Health psychology: history, definition and fields of application.

We describe how this discipline emerged and what are its characteristics and objectives.

There are a large number of disciplines within psychology. While some of them focus on research, the group setting or clinical practice, health psychology is focused on research, the group setting or clinical practice, health psychology focuses on the promotion of health and the psychological treatment of the and the psychological treatment of physical illness.

In this article we will review the history of this branch of the profession, contextualize it, define it and describe its objectives.

What do we mean by "health"?

In the preamble to its Constitution, drafted in 1948, the World Health Organization defined health as "a state of complete physical, mental and social well-being. complete physical, mental and social well-beingand not merely the absence of disease or infirmity.

The definition itself emphasizes making a distinction with the old conception of health as simply the absence of physical problems; nowadays, the term "health" is used to refer also to psychosocial variables that influence human biology, which gives a key role biology, which gives a key role to health psychology.

Other definitions place health and disease on a continuum. Thus, at one end we would find total health, while at the other end we would find premature death due to the absence of health.

In addition, increasing importance is being given to the understanding of health as a state and as a resource for achieving health goals. and as a resource for achieving the goals and meeting the needs of individuals and and needs of individuals and social groups in relation to their environment.

History of Health Psychology

The functions currently performed by health psychology have traditionally been the object of attention of various disciplines.

We can consider that the emergence of health psychology was a slow and progressive process. There are several key moments and contributions that must be mentioned in order to understand the development of this field.

The biomedical model and the biopsychosocial model

Traditionally, health has been understood health from a dualistic perspective that separates that separates the body and the mind. This point of view would be encompassed in what we know as the "biomedical model", which became popular in the West during the Renaissance, a period in which there was a reencounter with science and reason, overcoming the religious explanations that prevailed at the time.

In the late 19th and early 20th centuries, progress in medicine brought about a change of direction in this and related fields. In addition to the improvement in medical interventions and in the quality of life. In general, infectious diseases, which until then had been the main focus of medicine, could be treated more effectively. This shifted the attention of medicine to chronic lifestyle diseases, such as Cardiovascular disorders and cancer.

The biopsychosocial model proposed by Engel eventually replaced the biomedical model. In contrast to the biomedical model, the biopsychosocial model emphasizes the relevance and interaction of psychological and social factors alongside biological ones. This perspective raises the need for personalized and interdisciplinary treatments, since intervention must address all three types of variables.

Influences and antecedents

Johnson, Weinman, and Chater (2011) point to several nearby antecedents central to the emergence of health psychology as an independent discipline.

These include the collection of epidemiological data linking behavior to healthThe emergence of psychophysiology and psychoneuroimmunology, and the addition of behavioral science and communication skills (to improve patient relations) to medical training.

Also fundamental was the development of disciplines such as Psychosomatic Medicine and Behavioral Medicine.. Both focus on the treatment of physical illness through psychological intervention techniques, although Psychosomatics emerged from psychodynamic approaches and Behavioral Medicine from behaviorism.

Currently the term "Behavioral Medicine" is used to name an interdisciplinary field that encompasses contributions from psychology but also from other sciences, such as pharmacology, nutrition, sociology or immunology. This gives it a broader scope of action than health psychology.

The emergence of health psychology as a discipline

In 1978, the American Psychological Association created its 38th Division: that pertaining to Health Psychology. Joseph D. Matarazzo was appointed its president and Division 38 soon after launched its first handbook ("Health Psychology. A handbook") and an official journal.

Since then, health psychology has specialized in the treatment of physical and psychological illnesses. treatment of physical and psychological illnesses, such as depression.such as depression. However, the advancement of this branch of psychology has been faster in some countries than in others due to its relationship with public health; for example, in Spain the low government investment in psychology makes health psychology a relatively rare specialization.

Defining Health Psychology: what is it?

Although health psychology has no official definition, Matarazzo (1982) described it as a field that encompasses diverse contributions of health psychology. encompasses diverse contributions of psychology in relation to education in relation to education, science and profession, applied to health and illness.

The American Psychological Association proposes that health psychology is an interdisciplinary field that applies the knowledge gained by psychology to health and illness in the context of health and illness. to health and illness in health programs.. These interventions are applied in primary care or medical units.

Thielke et al. (2011) describe four subdisciplines within Health Psychology: clinical health psychology, public health psychology, community health psychology, and critical health psychology aimed at health-related social inequalities.

Differences with Clinical Psychology

What exactly are the differences between Health Psychology and Clinical Psychology? In Spain, it is easy to confuse these two branches of psychology, since they both fit with the idea of intervention in patients with problems that make them suffer or limit their autonomy. However, they do not deal with exactly the same thing, they do not deal with exactly the same thing.

Clinical Psychology aims to diagnose and offer psychotherapy to people who may have developed a psychological disorder, i.e. it targets mental health in the face of cognitive, emotional or behavioral alterations whose severity sometimes exceeds the clinical threshold and damages mental health. Health Psychology, on the other hand, does not focus its efforts on psychotherapy to reverse the symptoms of OCD, bipolar disorder or other similar complications, but rather tries to promote the patient's healthy habits in a broad sense, as well as to ensure that he or she is informed and knows how to prevent and cushion the discomfort produced by a given physical or mental illness.

However, it should be borne in mind that this difference in categories depends on the regulations of each country.In some places, Clinical Psychology could be practically synonymous with Health Psychology.

Objectives

For Matarazzo, Health Psychology has several determined goals that we will describe below.

1. Health promotion

This is one of the most characteristic aspects of Health Psychology. Traditionally, medicine has been insufficient in the treatment of a good number of diseases, especially those that are chronic and require a change in habits, such as cardiovascular diseases or respiratory problems due to tobacco consumption.

Psychology has a greater number of resources available to improve adherence to treatment and to improve adherence to treatment and the relationship between the professional and the patient. between the professional and the patient. Both variables have been shown to be fundamental in the efficacy of medical treatments.

2. Disease prevention and treatment

Both Medicine and Clinical Psychology have historically focused on the treatment of disease (physical and mental, respectively). However, both have neglected disease prevention, an essential aspect for the attainment of full health.

Health Psychology has been applied to a large number of physical illnesses. These include cardiovascular disorders, cancer, asthmaThese include cardiovascular disorders, cancer, asthma, irritable bowel syndrome, diabetes and chronic pain, such as fibromyalgia or headaches.

Likewise, Health Psychology is key in the prevention of problems derived from prevention of problems derived from unhealthy habits, such as those unhealthy habits, such as those caused by smoking or obesity.

3. Identification of etiologic and diagnostic correlates

Health psychology should not only be dedicated to applied tasks of disease prevention and treatment, but also to actively investigate what factors influence its onset and on its onset and course.

In this sense, health psychology would include contributions from epidemiology, basic psychology and other fields of research useful for various health-related disciplines.

4. Analysis and improvement of the health system

This aspect of health psychology is key and implies a political component, in the sense that the health measures recommended by health psychology professionals should be implemented through the health care system. implemented through the public health system in order to reach a larger number of people.

However, as we have said previously, depending on the country in which we find ourselves, this objective is still somewhat utopian.

Perspectives in this area

There are two main perspectives on the direction to be taken by health psychology, which is currently still a very young field.

One of them proposes that the discipline should specialize in bringing the knowledge of psychology to physical illness; health psychology would therefore be conceived as an equivalent to physical health as clinical psychology is to mental health. what clinical psychology is to mental health.. However, this entails a throwback to the dualistic conception of the human being, with the separation of body and mind as separate entities.

The other point of view proposes rather that Clinical Psychology and Health Psychology actually belong to the same field of action. The major difference between the two would be the emphasis on prevention in health psychology, as opposed to the traditional focus of clinical psychology on the pathological.

Bibliographical references:

• Amigo Vázquez, I., Fernández Rodríguez, C. & Pérez Álvarez, M. (2003). Manual de psicología de la salud. Madrid: Pirámide.
• Johnson, M., Weinman, J. & Chater, A. (2011). A healthy Contribution. Health Psychology, 24(12); 890-902.
• Matarazzo, J. D. (1982). Behavioural health’s challenge to academic, scientific and professional psychology. American Psychologist, 37; 1–14.
• Thielke, S.,Thompson, A. & Stuart, R. (2011). Health psychology in primary care: recent research and future directions. Psychology Research and Behavior Management, 4; 59-68.